| NPI | 1497952923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN EDWARD GREENE President 860-889-8427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CT 009537) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2014-06-20 |